Of shaken beers and dropped laptops – Reflections and informations on getting through ankle surgery (microfracture and brostrom ligament repair)

If I had a nickel for every time I’ve watched my damn crutches go crashing to the floor in a clattering heap, I’d be making a profit on this whole deal.

I find myself thinking about Long John Silver. A lot. Was his crutch better than mine? Did he ever manage to carry a cup of grog more than three feet without throwing it all over the walls? Could this character really have existed and gotten so much done while hopping around on one foot? Arrrrrrr!

I have been avoiding beer all these weeks, because I want to avoid its diuretic effects and extra ambulation that entails. And there’s another thing. I don’t particularly like them shaken all to hell, which is your only choice if a beverage is going to ride in your hand or the drink holder on your crutches while you attempt to drag your carcass from a to b. But last night I decided to indulge in a bottle of nice beer (oboy oboy oboy, my preciousss). I put it in a bag and carried the bag on my back to get down the stairs and to the other room where I would bivouac (you can’t just go somewhere when you’re on crutches. every movement requires planning and provisions and a projected length of stay). Nonetheless, before I could open it and begin to enjoy my little prize, the bottle somehow ended up falling out of the bag, banging on the floor, and rolling away from me across the room, while I just leaned on my crutches like a helpless idiot, watching it go. I could see it turning to foam inside the bottle as it rolled away. ‘Yup, there it goes,’ I thought.

Bottom line: Sippy cups, Euro crutches, Iceman, Exercise. And a spouse/significant other who is bound to you by vows, law, guilt, blackmail, or binding magic of some kind, preferably who has a good sense of personal cost-benefit-analysis. Or, y’know, love and stuff.

If I could do it all over again: I’d buy an Airdyne exercise bike (the kind where you pull with your hands in addition to pedaling), and ideally, some kind of motorized tricycle, quad, or golf cart that can be controlled entirely by hands and left foot, and won’t fall over. ‘Cause the surgery was on my right foot, and the inability to get around at all on your own is exasperating.

Anaesthesia: I elected to have a spinal, with no sedative. It’s not that bad. You roll on your side, they give you a little local anesthetic shot in your back, and then administer the spinal anesthetic and you lie back down. then your lower back and butt starts to feel a little funny, in my case it felt good, like all the tension was running out of my lower body and it was sort of glowing. or something. Anyway, then there’s a motorized tourniquet around your leg somewhere that you can’t feel anyway. In my case I could just see the video screen the surgeon was using to see inside my ankle. So I could watch the entirety of the arthroscopic procedure, which was great. There is a cloth screen across your waist, and the anesthesiologist sits next to you and keeps you company. With the various monitors attached to me I had something else to watch, and made a game of trying to get my heart rate down (46 bpm was my best). I’m not going to pretend it wasn’t disturbing, because it was. I mean it’s surgery. Somebody is cutting on you and that shouldn’t feel right or hunky dory. But after a little while I got into it and watched the little video screen and focused on how cool it was that this awful nagging injury was getting fixed right before my eyes, and I got to see exactly how. It is a small miracle really. It is something you could simply never possibly do yourself, and here it is happening, being executed with the utmost skill and modern techniques, a team of people fixing your parts, while you wait so to speak. To me this is preferable to having some vague period of lost time where something was done to me which I may never fully understand and waking up confused and feeling like I got hit by a truck. They said the spinal could take six hours to wear off, sitting in the recovery room. It didn’t. It took all of 45 minutes or so, the hardest part being convincing the staff that I was ready to crutch on out of there. And they gave me a private little room to recover in because of the spinal too, in case it took a long time, so I wouldn’t have to be in the fray of the recovery room. I watched as the general anesthesia victims were wheeled in one after another, confused, disoriented people who had to be spoken to like idiot children, gently encouraged to return and accept the reality the rest of us could plainly see. No thank you.

I had my computer, my music, things to read, and an urgency to get on my merry way home. So yes, while it was a little gory and disconcerting in there, I say go for it, two thumbs up. Perhaps the most disturbing thing will be how nonchalant the whole thing is for your surgical team. At times I wanted to tell the chatty cathy nurse to quit yammering on in my surgeon’s ear about nonsensical tripe so he could do his job. But the steady progress I was witnessing on the screen told me he is an expert at tuning her out. Or at least that’s what I hoped. I forgot to mention how the second surgery went, the ligament shortening. This is not arthroscopic. It’s good old fashioned, cut-a-big-hole-so-you-can-reach-your-big-human-hands-in-there kinda surgery. I could make out a little of what was going on via a shiny metal mount on the ceiling that the light was attached to. Basically it just looked like a lot of gloved hands crammed in a circle on my ankle, looking a bit like animals on a kill perhaps. Even if I’d had a nice mirror, I wouldn’t have been able to see much. So that part was a little boring. All I could do was chat with the anesthesiologist and ask him questions about the surgery and what was happening here and there. Then pretty soon there suturing it up and you’re almost out of the OR. The OR, by the way, was a fairly large room, with me in the middle, lots of light, and equipment all over the place. Honestly it felt a bit like being in some kind of equipment room or large maintenance closet. Sort of a utility room with tools and stuff here and there around the periphery. Mostly open space. When you’re done, they team up and lift you over onto the wheelie cart-bed and out you go. You’re done!

I’d be remiss, I suppose, if I didn’t mention the most disturbing part of the microfracture procedure. The actual microfracture is a process of making holes in the bone surface of your joint. I was imagining a drill on the end of fancy micro-robot arm or something. It was a bit more medieval than that, a hammer and chisel (punch), to be specific. So there is some hammering. And it does shake your body. But hey, focus on the healing, right? It may feel like a baby sledge, but it’s really just the rhythmic love taps of Asclepius’ own staff, tappity-tapping into your bone to release the youthful fountain of stem cells and blood so you can be a fleet-footed Hermes once again. Once the careful, loving–and undistracted–hands of your skilled and confident surgeon have made enough holes (nobody kept count, but it was quite a few, a bit like those lines of holes woodpeckers make in trees, but don’t think about woodpeckers), they will loosen the tourniquet a bit and watch the screen to see that the blood comes out those holes like it’s sposed to, which was the only blood I saw the whole day, and it was on a vid screen. So there you go. I say ‘most disturbing’, but that’s not to assume it is very disturbing. It’s an odd sensation, to be sure. But whether it’s disturbing, I leave up to you, the patient, to decide for yourself. And remember, your buddy the anesthesiologist, is there to help you out anytime you need it. Drugs? He’s got drugs. In my case, the oddest thing was that it was in those creepiest, uh, oddest moments I mean, that my heart rate dipped the lowest. Weird. A reverse stress response perhaps? Surgery can be whole new experience, an interesting event in your life. Memorable. And if it’s not going that way for you when it’s going down, just say ‘hey, new buddy, hit me’, and it can all be gone, off to la-la land for you hermes. See ya in recovery.

Oh, also. I forgot to mention. No need for catheters in your stuff, at least with the spinal. One thing they do say about the spinal though. You may never pee again. Okay not really. But the first time after the spinal is a triumph you shall tell your grandkids about. And one that few men have had, so there’s that.

Another odd sensory portion of the ligament surgery was a brief whiff of burning flesh due to the cauterizing scalpel. No big deal.

It’s been 5 weeks now since surgery. I am more accustomed now to being crippled but still not liking it. Every day starts with the pain in my hands when I stand with the crutches and take my first steps. About those crutches: After the surgery I had both the usual American crutches, that go up to your armpits, and European crutches, that go up to your forearms. I immediately selected the Euro crutches. They are short and tactical. I can easily get into the car and hold them across my lap, ready to get out of the car again, crutches in front of me. I can climb stairs four at a time. Let me tell you, this is a big deal. Down stairs I can do even more. It is like having huge long front limbs that you can still bend at the elbow. It’s a bit like being one of those big strider beasts in The Dark Crystal. If you haven’t seen that movie, you really should.

With the shortie Euro crutches, I am constantly working my arms and shoulders, which is good. When I climb stairs four at a time, at least I feel like I’m accomplishing something, there is a challenge beyond the tedium of being really slow and lousy at getting around. The tradeoff is that all the weight goes into your hands. Again and again and again. And again. I have gone through about 5 different versions of improvised grip designs now. The stock grips they came with were beautifully sculpted and cushioned, but the angle was wrong. They tweaked my wrists at almost a right angle, putting a ton of stress on them. From Judo (and pretty much every martial art) I have learned that a straight wrist is strong. The stock grips were also left and right specific, rather than ambidextrous, which turned out to be a real pain when you have to put down and pick up your crutches a thousand times a day. Having to sort out right and left every damn time is an extra pain in the ass added to an already annoying practice. In the end, I managed to take the foamie grips off my American crutches and cram them onto the Euro crutch handles, after carving down some plastic ridges that were in the way on the Euro crutches. To this I added a little rubber pad at the base of the grip made from bicycle inner tube pieces. This puts the ulnar side of my palm (opposite the thumb side) on a higher pad and evens out the pressure across the base of my palm, keeping the hand straight. To this I eventually added a pair of long, thick ski socks, pulled over the grip and doubled back a few times to create a big cushy wad of padding to grab onto. I take these on and off periodically to vary how I’m using my hands. I don’t want my hands always curled into the same shape like little gnarled claws. Frequently changing the grip size helps with this a bit.

My personal best on stairs is 5 steps at once going up, and 7 steps going down, not including the starting step. These are the little games that help keep you going.

And then there is the most important crutch mod: a goddamn drink holder. Guess what? when you are crutches you can’t carry things! I took a bicycle water bottle cage and attached it to the back of the crutch with some short, fat, self-tapping screws. You must have this. It is essential equipment. In addition, my lovely spouse/driver took me to the neighborhood REI store where I bought a selection of grown-up sippy cups. A super thermos mug for coffee and such, another mug with carabiner clip handle (ended up not being so useful, but still like it and use it), a drink bottle with sucker-nipple thing, and lastly, a rather cute little insulated cup for grown-up drinky-drinks. Ha!

For the microfracture, all you get is this little love bite. The left one’s for the camera, the right one, just visible, is for the tools. 1 week post surgery.

If you get the Brostrom, this little beauty can be yours.Hey, maybe I should just add to it and make a happy face.

This is the most important thing in the whole blog. A bike bottle cage attached to the crutch with a couple of coarse thread screws